Test inmates for immunity to valley fever, report urges

Associated Press

Published 5:15 pm, Friday, July 25, 2014

Sacramento --

Federal experts are recommending that California test inmates for immunity to a sometimes fatal soil-borne fungus before incarcerating them at two Central Valley state prisons where the disease has killed nearly three dozen inmates, according to a report released Friday.

A federal judge last fall ordered the state to move nearly 2,600 susceptible inmates out of Avenal and Pleasant Valley state prisons because of the deaths and illnesses.

The Centers for Disease Control and Prevention recommended the state go further by using hypersensitivity skin tests that could identify inmates who already were exposed to valley fever. Those inmates could thus safely be housed at the two state prisons near Fresno because they largely are immune to repeat infections.

The experts said that is a better option than the current practice of screening out black and Filipino inmates and others who statistically are more susceptible to the fungus, which grows naturally in the soil in the Central Valley and other dry locations such as Arizona and Mexico.

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They project that systemwide testing would find 13 percent of the prison population is immune because the inmates previously were exposed.

Joyce Hayhoe, a spokeswoman for the federal court-appointed receiver who controls prison medical care, said the office is reviewing the report.

Don Specter, director of the nonprofit Prison Law Office in Berkeley, said the state should start testing inmates as soon as possible. His firm persuaded U.S. District Judge Thelton Henderson of San Francisco to order vulnerable inmates removed from the two prisons last year.

Skin tests would sharply reduce the number of infections, the experts said.

About 5 percent of inmates at the two prisons would be expected to be infected annually if no steps were taken, according to the 52-page report. Using the skin tests would reduce that to about 2 percent, preventing a projected 268 cases each year.

With the commercially available skin test, approved this month by the U.S. Food and Drug Administration, inmates would be injected with a noninfectious strain and evaluated 48 hours later.

Inmates would have the right to refuse to be tested, Hayhoe said.

The steps the state already has taken, including removing black and Filipino inmates, should reduce annual infections only slightly, preventing 44 infections annually, the experts projected.

At their peak in 2011, valley fever infections at the two prisons were up to 153 times higher than surrounding areas, researchers found. The two prisons combined to produce 83 percent of valley fever cases in the entire prison system, which includes about 135,500 inmates in 34 state prisons as well as private prisons in California and other states.

The same year, more than 20,000 cases were reported nationwide among the general population, most of them in Arizona and California.

Prison infections declined in 2012, but were still more than 20 times higher than among the general surrounding population. State officials say valley fever was killing six to nine inmates each year and costs the state more than $23 million annually to care for infected inmates and employees.

The fungus usually produces no symptoms, but in about 40 percent of cases it causes mild to severe flu-like symptoms or more serious infections. Valley fever can spread to the brain, bones, skin and eyes, leading to blindness, skin abscesses, lung failure and death.